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不同融合器短节段颈椎前路手术后矢状面平衡参数及临床疗效的回顾性分析

Retrospective Analysis of Sagittal Balance Parameters and Clinical Efficacy After Short-Segment Anterior Cervical Spine Surgery with Different Fusion Devices.

作者信息

Wei Zihan, Zhang Ying, Yang Sizhen, Cai Chenhui, Ye Jiawen, Qiu Hao, Hu Xu, Qu Yiyun, Wen Xuan, Chu Tongwei

机构信息

Department of Orthopedics, Xinqiao Hospital of Chongqing, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People's Republic of China.

出版信息

Int J Gen Med. 2022 Mar 22;15:3237-3246. doi: 10.2147/IJGM.S340877. eCollection 2022.

Abstract

OBJECTIVE

To compare the cervical sagittal balance parameters and clinical efficacy of three fusion devices after short-segment anterior cervical discectomy and fusion.

PATIENTS AND METHODS

Retrospectively analyzed 516 patients with cervical spondylosis who underwent surgery at our hospital from May 2013 to May 2019. All patients had complete data and were divided into three groups according to the selected fusion cage. Neck and upper limb pain were assessed by the visual analog scale (VAS) score. Neurological function was evaluated by the modified Japanese Orthopedics Society (mJOA) score. Also, the curvature of the cervical spine and the occurrence of dysphagia were observed.

RESULTS

There were no significant differences in the general information, thoracic inlet angle, T1 slope, or surgical data among the groups (>0.05). There were significant differences in the scores between pre- and postoperatively in the different groups (<0.05). There were no significant differences in the C2-C7 Cobb angle or C2-C7 sagittal vertebral axis before the operation among the groups (>0.05). There was a significant difference in the correction and loss of correction among the groups postoperatively and on follow-up (>0.05). Dysphagia was less likely in the Zero-P VA fusion group than in the other two groups.

CONCLUSION

Different fusion instruments can relieve the symptoms. In the Prodisc-C Vivo group, no significant improvement in cervical sagittal balance was achieved. A good effect on improving sagittal balance was observed in both the Zero-P VA fusion and Skyline anterior cervical titanium plate groups, but a better effect on preventing dysphagia was observed in the Zero-PVA fusion group.

摘要

目的

比较短节段颈椎前路椎间盘切除融合术后三种融合器械的颈椎矢状面平衡参数及临床疗效。

患者与方法

回顾性分析2013年5月至2019年5月在我院接受手术的516例颈椎病患者。所有患者资料完整,根据所选融合器分为三组。采用视觉模拟量表(VAS)评分评估颈部和上肢疼痛。采用改良日本骨科学会(mJOA)评分评估神经功能。同时,观察颈椎曲度及吞咽困难的发生情况。

结果

各组间一般资料、胸廓入口角、T1斜率或手术数据无显著差异(>0.05)。不同组术前和术后评分有显著差异(<0.05)。术前各组间C2-C7 Cobb角或C2-C7矢状椎体轴无显著差异(>0.05)。术后及随访时各组间矫正及矫正丢失有显著差异(>0.05)。Zero-P VA融合组吞咽困难的发生率低于其他两组。

结论

不同的融合器械均可缓解症状。在Prodisc-C Vivo组中,颈椎矢状面平衡未得到显著改善。Zero-P VA融合组和Skyline颈椎前路钛板组在改善矢状面平衡方面均有良好效果,但Zero-P VA融合组在预防吞咽困难方面效果更佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea47/8957297/4583af345002/IJGM-15-3237-g0001.jpg

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